KaydedilenlerDerginizi ekleyin

Dergiler / Mersin Üniversitesi Sağlık Bilimleri Dergisi / 2026 / Cilt: 15 Sayı: 1

Geriatrik disfaji ve beslenme tedavisi

Geriatric dysphagia and nutritional therapy

Büşra Özyalçın(ANKARA MEDİPOL ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ)0000-0001-5872-179X
Nevin Şanlıer(ANKARA MEDİPOL ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0001-5937-0485
Sayfa
100–109
Yayın Tarihi
2022-04-30
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Ancak disfajide beslenme için netlik olmadığından bu derleme çalışma, geriatrik disfaji ve beslenme tedavisine ilişkin bilgileri sunmak amacıyla planlanmış ve yürütülmüştür.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Yaşlı bireylerin, 2050 yılında gelişmiş ülkelerdeki nüfusun %25'ini oluşturacağı tahmin edilmektedir.
📊
Temel Bulgular & Veri:Son dönemde disfajinin, geriatrik sendrom olarak tanınmasına dair artan farkındalık mevcuttur.
💡
Sonuç & Katkı:Ancak disfajide beslenme için netlik olmadığından bu derleme çalışma, geriatrik disfaji ve beslenme tedavisine ilişkin bilgileri sunmak amacıyla planlanmış ve yürütülmüştür.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:2050 Verileri
⚙️Değişkenler:Beslenme Tedavisi · disfaji · geriatri

Özet

Yaşlı bireylerin, 2050 yılında gelişmiş ülkelerdeki nüfusun %25'ini oluşturacağı tahmin edilmektedir. Yaşlanmanın fizyolojisi ile birlikte yaşlı bireylerde disfaji, önemli bir sağlık sorunu olarak ortaya çıkabilmektedir. Disfaji, nöromüsküler bozukluk veya mekanik tıkanmadan kaynaklanabilen yutma güçlüğüdür. Malnütrisyon, dehidratasyon ve aspirasyon pnömonisi gibi birçok komplikasyonu da beraberinde getirmektedir. Son dönemde disfajinin, geriatrik sendrom olarak tanınmasına dair artan farkındalık mevcuttur. Yaşlılarda disfaji yaşlanmanın normal bir parçası olarak düşünüldüğü için fark edilmeyebilmektedir. Bu durumda hastalığın ilerlemesine ve beraberinde komplikasyonları getirmesine yol açmaktadır. Disfaji için doğru teşhis ve multidisipliner yaklaşım tedavide başarıyı getirmektedir. Yaşlılarda disfaji tedavisi için standart bir yaklaşım bulunmamaktadır. Disfaji tedavileri arasında duruş ayarlamaları, besin ve sıvı oranı-miktarı, diyet değişikliği, ağız sağlığı, yutma rehabilitasyonu ve farmakolojik tedavi gibi diğer yaklaşımlar yer almaktadır. Disfajide beslenme için dokusu değiştirilmiş diyetlerin kullanımı tavsiye edilmektedir. Tüm bakım ortamları için ve her yaştan disfajili bireyler tarafından kullanılan dokusu değiştirilmiş besinleri ve koyulaştırılmış sıvıları tanımlamak için Uluslararası Disfaji Diyet Standardizasyon Girişimi kurulmuştur. Bazı kılavuzlarda disfaji hastaları için beslenme önerileri mevcuttur. Ancak disfajide beslenme için netlik olmadığından bu derleme çalışma, geriatrik disfaji ve beslenme tedavisine ilişkin bilgileri sunmak amacıyla planlanmış ve yürütülmüştür.

Abstract

It is estimated that elderly individuals will constitute 25% of the population in developed countries by 2050. Along with the physiology of aging, dysphagia can emerge as an important health problem in elderly individuals. Dysphagia is swallowing difficulty that may result from neuromuscular disorder or mechanical obstruction. It also brings many complications such as malnutrition, dehydration and aspiration pneumonia. Recently, there has been increasing awareness of the recognition of dysphagia as a geriatric syndrome. Dysphagia in the elderly may go unnoticed as it is considered a normal part of aging. In this case, it leads to the progression of the disease and to its complications. Accurate diagnosis and multidisciplinary approach for dysphagia bring success in treatment. There is no standard approach for the treatment of dysphagia in the elderly. Dysphagia treatments include posture adjustments, nutrient and fluid ratio-amount, diet change, oral health, swallowing rehabilitation, and other approaches such as pharmacological treatment. The use of tissue modified diets is recommended for nutrition in dysphagia. The International Dysphagia Dietary Standardization Initiative was established to define tissue-modified foods and thickened fluids used for all care settings and by individuals of all ages with dysphagia. Some guidelines have nutritional recommendations for patients with dysphagia. However, since there is no certainness for nutrition in dysphagia, this review study was planned and conducted to present information on geriatric dysphagia and nutritional therapy.

🔖

Bu Makaleye Atıf Yap

Özyalçın, B., Şanlıer, N. (2022). Geriatrik disfaji ve beslenme tedavisi. Mersin Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 15 Sayı: 1, 100–109. https://doi.org/10.26559/mersinsbd.972414

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (45)

  1. T. C. Aile Çalışma ve Sosyal Hizmetler Bakanlığı. Engelli ve Yaşlı Hizmetleri Genel Müdürlüğü. Erişim adresi: yasli-nufus-demografik-degisimi-2020.pdf (ailevecalisma.gov.tr). Erişim tarihi: 24.06.2021.
  2. Logrippo S, Ricci G, Sestili M, Cespi M, Ferrara L, Palmieri GF, et al. Oral drug therapy in elderly with dysphagia: between a rock and a hard place! Clin Interv Aging. 2017;12:241. doi:https://doi.org/10.2147/cia.s121905
  3. Christmas C, Rogus‐Pulia N. Swallowing disorders in the older population. J Am Geriatr Soc. 2019;67(12):2643-2649. doi:https://doi.org/10.1111/jgs.16137
  4. Mehraban-Far S, Alrassi J, Patel R, Ahmad V, Browne N, Lam W. Dysphagia in the elderly population: A Videofluoroscopic study. Am J Otolaryngol. 2021;42(2):102854. doi:https://doi.org/10.1016/j.amjoto.2020.102854
  5. Di Pede C, Mantovani ME, Del Felice A, Masiero S. Dysphagia in the elderly: focus on rehabilitation strategies. Aging Clin Exp Res. 2016;28(4):607-617. doi:https://doi.org/10.1007/s40520-015-0481-6
  6. Furuya H, Kikutani T, Igarashi K, Sagawa K, Yajima Y, Machida R, et al. Effect of dysphagia rehabilitation in patients receiving enteral nutrition at home nursing care: a retrospective cohort study. J Oral Rehabil. 2020;47(8):977-982. doi: https://doi.org/10.1111/joor.13030
  7. Li M, Wang Z, Han WJ, Lu SY, Fang YZ. Effect of feeding management on aspiration pneumonia in elderly patients with dysphagia. Chinese Nursing Research. 2015;2(2-3):40-44. doi:https://doi.org/10.1016/j.cnre.2015.09.004
  8. Raheem D, Carrascosa C, Ramos F, Saraiva A, Raposo A. Texture-Modified Food for Dysphagic Patients: A Comprehensive Review. Int J Environ Res Public Health. 2021;18(10):5125. doi:https://doi.org/10.3390/ijerph18105125
  9. Sunata K, Terai H, Seki H, Mitsuhashi M, Kagoshima Y, Nakayama S, et al. Analysis of clinical outcomes in elderly patients with impaired swallowing function. PLoS One. 2020;15(9):e0239440. doi:https://doi.org/10.1371/journal.pone.0239440
  10. Gallegos C, Brito-De La Fuente E, Clavé P, Costa A, Assegehegn G. Nutritional aspects of dysphagia management. Adv Food Nutr Res. 2017;81:271-318. doi:10.1016/bs.afnr.2016.11.008
  11. WHO ICD-11 for Mortality and Morbidity Statistics. Erişim adresi: ICD-11 - ICD-11 for Mortality and Morbidity Statistics (who.int). Erişim tarihi: 15.03.2021.
  12. Ortega O, Martín A, Clavé P. Diagnosis and management of oropharyngeal dysphagia among older persons, state of the art. J Am Med Dir Assoc. 2017;18(7):576-582. doi: https://doi.org/10.1016/j.jamda.2017.02.015
  13. Clavé P, Rofes L, Carrión S, Ortega O, Cabré M, Serra-Prat M, et al. Pathophysiology, relevance and natural history of oropharyngeal dysphagia among older people. Nestle Nutr Inst Workshop Ser. 2012;72:57-66. doi:https://doi.org/10.1159/000339986
  14. World Gastroenterology Organisation Global Guidelines. Dysphagia, Global Guidelines & Cascades. Update September 2014. Erişim adresi: https://www.spg.pt/wp-content/uploads/2015/11/2014-dysphagia.pdf. Erişim tarihi: 20.04.2021.
  15. Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12(5):259. doi:https://doi.org/10.1038/nrgastro.2015.49
  16. Olesen MD, Modlinski RM, Poulsen SH, Rosenvinge PM, Rasmussen HH, Holst M. Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit. Clin Nutr ESPEN. 2021;41:208-216. doi:https://doi.org/10.1016/j.clnesp.2020.12.020
  17. Maeda K, Akagi J. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly. Dysphagia. 2015;30(1):80-87. doi:https://doi.org/10.1007/s00455-014-9577-y
  18. Shimizu A, Fujishima I, Maeda K, Wakabayashi H, Nishioka S, Ohno T, et al. Effect of low tongue pressure on nutritional status and improvement of swallowing function in patients with sarcopenic dysphagia. Nutrition. 2021;90:111295. doi:https://doi.org/10.1016/j.nut.2021.111295
  19. Namasivayam-MacDonald AM, Morrison JM, Steele CM, Keller H. How swallow pressures and dysphagia affect malnutrition and mealtime outcomes in long-term care. Dysphagia. 2017;32(6):785-796. doi:https://doi.org/10.1007/s00455-017-9825-z
  20. Nawaz S, Tulunay-Ugur OE. Dysphagia in the older patient. Otolaryngol Clin North Am. 2018;51(4):769-777. doi:https://doi.org/10.1016/j.otc.2018.03.006
  21. Wirth R, Dziewas R, Beck AM, Clave P, Hamdy S, Heppner HJ, et al. Oropharyngeal dysphagia in older persons–from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016;11:189-208. doi:https://doi.org/10.2147/cia.s97481
  22. Robbins J, Humpal NS, Banaszynski K, Hind J, Rogus-Pulia N. Age-related differences in pressures generated during isometric presses and swallows by healthy adults. Dysphagia. 2016;31(1):90-96. doi:https://doi.org/10.1007/s00455-015-9662-x
  23. Park D, Lee HH, Lee ST, Oh Y, Lee JC, Nam KW, et al. Normal contractile algorithm of swallowing related muscles revealed by needle EMG and its comparison to videofluoroscopic swallowing study and high resolution manometry studies: a preliminary study. J Electromyogr Kinesiol. 2017;36:81-89. doi:https://doi.org/10.1016/j.jelekin.2017.07.007
  24. Carrión S, Cabré M, Monteis R, Roca M, Palomera E, Serra-Prat M, et al. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2015;34(3):436-442. doi:https://doi.org/10.1016/j.clnu.2014.04.014
  25. Tulunay-Ugur OE, Eibling D. Geriatric dysphagia. Clin Geriatr Med. 2018;34(2):183-189. doi:https://doi.org/10.1016/j.cger.2018.01.007
  26. Baijens LW, Clavé P, Cras P, Ekberg O, Forster A, Kolb GF, et al. European Society for Swallowing Disorders–European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403. doi:https://doi.org/10.2147/cia.s107750
  27. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919-924. doi:https://doi.org/10.1177/000348940811701210
  28. Mañas-Martínez AB, Bucar-Barjud M, Campos-Fernández J, Gimeno-Orna JA, Pérez-Calvo J, Ocón-Bretón J. Association of positive screening for dysphagia with nutritional status and long-term mortality in hospitalized elderly patients. Endocrinol Diabetes Nutr (Engl Ed). 2018;65(7):402-408. doi:https://doi.org/10.1016/j.endinu.2018.02.004
  29. Rofes L, Arreola V, Almirall J, Cabré M, Campins L, García-Peris P, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2010;2011. doi:https://doi.org/10.1155/2011/818979
  30. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47. doi:https://doi.org/10.1016/j.clnu.2018.05.024
  31. Carrión S, Roca M, Costa A, Arreola V, Ortega O, Palomera E, et al. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation. Clin Nutr. 2017;36(4):1110-1116. doi:https://doi.org/10.1016/j.clnu.2016.07.009
  32. Homem SG, Moreira EAM, da Silva AF, Barni GC, da Rosa JS, de Lima Oliveira D, et al. Relationship between oropharyngeal dysphagia, nutritional status, antioxidant vitamins and the inflammatory response in adults and elderly: A cross-sectional study. Clin Nutr ESPEN. 2020;38:211-217. doi:https://doi.org/10.1016/j.clnesp.2020.04.011
  33. Reyes-Torres CA, Castillo-Martínez L, Reyes-Guerrero R, Ramos-Vázquez AG, Zavala-Solares M, Cassis-Nosthas L, et al. Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial. Eur J Clin Nutr. 2019;73(7):989-996. doi:https://doi.org/10.1038/s41430-019-0389-x
  34. O’Keeffe ST. Use of modified diets to prevent aspiration in oropharyngeal dysphagia: is current practice justified? BMC Geriatr. 2018;18(1):167. doi:https://doi.org/10.1186/s12877-018-0839-7
  35. Andersen UT, Beck AM, Kjaersgaard A, Hansen T, Poulsen I. Systematic review and evidence based recommendations on texture modified foods and thickened fluids for adults (≥18 years) with oropharyngeal dysphagia. e-SPEN Journal. 2013;8(4):e127-e134. doi:http://dx.doi.org/10.1016/j.clnme.2013.05.003
  36. Beck AM, Kjaersgaard A, Hansen T, Poulsen I. Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia-An updated clinical guideline. Clin Nutr. 2018;37(6):1980-1991. doi:https://doi.org/10.1016/j.clnu.2017.09.002
  37. Howard MM, Nissenson PM, Meeks L, Rosario ER. Use of textured thin liquids in patients with dysphagia. Am J Speech Lang Pathol. 2018;27(2):827-835. doi:https://doi.org/10.1044/2018_ajslp-16-0140
  38. Ullrich S, Crichton J. Older people with dysphagia: transitioning to texture-modified food. Br J Nurs. 2015;24(13):686-692. doi:https://doi.org/10.12968/bjon.2015.24.13.686
  39. Sestili M, Logrippo S, Cespi M, Bonacucina G, Ferrara L, Busco S, et al. Potentially inappropriate prescribing of oral solid medications in elderly dysphagic patients. Pharmaceutics. 2018;10(4):280. doi:https://doi.org/10.3390/pharmaceutics10040280
  40. The National Dysphagia Diet Task Force, The National Dysphagia Diet: standardization for optimal care. American Dietetic Association. 2002.
  41. Academy of Nutrition and Dietetics (AND). Erişim adresi: https://www.eatrightpro.org/practice/practice-resources/post-acute-long-term-care-management/international-dysphagia-diet-standardization-initiative. Erişim tarihi: 04.05.2021.
  42. International Dysphagia Diet Standardisation Initiative (IDDSI). Erişim adresi: https://iddsi.org/IDDSI/media/images/Complete_IDDSI_Framework_Final_31July2019.pdf. Erişim tarihi: 23.04.2021.
  43. Brewsaugh AM, Brust LJ, Hartman J. Implementing the International Dysphagia Diet Standardization Initiative: Opportunities for Change. J Acad Nutr Diet. 2021. doi:https://doi.org/10.1016/j.jand.2021.02.012
  44. Burgos R, Bretón I, Cereda E, Desport JC, Dziewas R, Genton L, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr. 2018;37(1):354-396. doi:https://doi.org/10.1016/j.clnu.2017.09.003
  45. Volkert D, Berner YN, Berry E, Cederholm T, Bertrand PC, Milne A, et al. ESPEN guidelines on enteral nutrition: geriatrics. Clin Nutr. 2006;25(2):330-360. doi:https://doi.org/10.1016/j.clnu.2006.01.012